Journal
ETHNICITY & DISEASE
Volume 31, Issue -, Pages 375-388Publisher
INT SOC HYPERTENSION BLACKS-ISHIB
DOI: 10.18865/ed.31.S1.375
Keywords
School Connectedness; Implementation Science; Health Disparities
Categories
Funding
- National Institutes of Minority Health and Health Disparities [R01MD0110586]
- National Heart, Lung, and Blood Institute [K23 HL143146]
Ask authors/readers for more resources
The study demonstrates the significant impact of structural racism on intervention implementation and uptake within a trial designed to enhance student-school connectedness. By adapting the Consolidated Framework for Implementation Research to a race-conscious frame, findings include the cascading influence of leaders' examination of BIPOC student and parent experiences, the complex relationship between principals' race/ethnicity and intervention engagement, the facilitative role of external change agents from BIPOC communities, and the racialized perceptions of highly networked implementation champions in enhancing intervention uptake.
Objectives: To use the Consolidated Framework for Implementation Research (CFIR) adapted to a race-conscious frame to understand ways that structural racism interacts with intervention implementation and uptake within an equity-oriented trial designed to enhance student-school connectedness. Design: Secondary analysis of qualitative implementation data from Project TRUST (Training for Resiliency in Urban Students and Teachers), a hybrid effectiveness-implementation, community-based participatory intervention. Setting: Ten schools across one urban school district. Methods: We analyzed qualitative observational field notes, youth and parent researcher reflections, and semi-structured interviews with community-academic researchers and school-based partners within CFIR constructs based on framing questions using a Public Health Critical Race Praxis approach. Results: Within most CFIR constructs and sub-constructs, we identified barriers to implementation uptake not previously recognized using standard race-neutral definitions. Themes that crossed constructs included: 1) Leaders' willingness to examine Black, Indigenous, People of Color (BIPOC) student and parent experiences of school discrimination and marginalization had a cascading influence on multiple factors related to implementation uptake; 2) The race/ethnicity of the principals was related to intervention engagement and intervention uptake, particularly at the extremes, but the relationship was complex; 3) External change agents from BIPOC communities facilitated intervention uptake in indirect but significant ways; 4) Highly networked implementation champions had the ability to enhance commitment to intervention uptake; however, perceptions of these individuals and the degree to which they were networked was highly racialized. Conclusions: Equity-oriented interventions should consider structural racism within the CFIR model to better understand intervention uptake.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available